This invention relates to a hemostatic clip applier, and, more particularly, to a pistol-type applier having an elongated tubular jaw assembly able to reach areas inaccessible to conventional forcep-type instruments.
In the course of a surgical operation, it is usually necessary to sever blood vessels which must be quickly clamped or ligated to prevent excessive bleeding which could interfere with the operation and pose unnecessary risks to the patient. While major blood vessels are temporarily clamped and later rejoined when the wound is closed, many severed vessels of the vascular system are permanently closed either because other vessels are available to serve their function, or because that portion of the anatomy being served by the vessel has been surgically removed.
Severed vessels are conventionally closed by either tying with ligatures or clamping with ligating clips. Ligating clips are often preferred, especially for permanent closure because of the ease and speed of placement, and the security of the closure. Clips are conventionally applied by means of a forceps-type applier as described, for example, in U.S. Pat. No. 3,439,522. These appliers work well in most general procedures where the severed vessel is accessible to the instrument. In certain procedures, however, particularly in otologic surgery or neurosurgery, a relatively small hole is made in the skull in order to reach and clip off certain blood or other vessels therein, and the small hole does not admit to the use of the forceps-type applier. In thoracic surgery, fluid ducts deep within the chest cavity are difficult to reach with a forceps-type instrument without disturbing other organs. For these and other specific applications, the surgeon may use a special applier having a long, slender nose such as that described in U.S. Pat. Nos. 3,518,993 or 3,777,538.
The long-nose surgical clip applicators of the prior art have certain disadvantages which are overcome by means of the present invention. In prior art applicators, the angle of the jaws holding the clip are fixed relative to the handles of the instrument so that the entire instrument must be maneuvered to align the clip with the vessel. Moreover, the length of the jaw assemblies of the prior art appliers are either permanently mounted or not readily changed so that the surgeon may often be forced to use a longer and more awkward instrument than necessary.
It is accordingly an object of the present invention to overcome the above and other disadvantages of the prior art instruments by providing a long-nose surgical clip applicator having a fully rotatable jaw member. It is a further object of this invention to provide a ligating clip applier with readily interchangeable jaw members of various lengths, and with jaws set at various angles to the main axis of the instrument. These and other objects of the present invention will be apparent from the ensuing description and claims.